Provider Demographics
NPI:1417609918
Name:QUINN, NANCY M (OTR/L)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:QUINN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:M
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:19048 OVERLOOK RD
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-4165
Mailing Address - Country:US
Mailing Address - Phone:408-460-3867
Mailing Address - Fax:
Practice Address - Street 1:1361 S WINCHESTER BLVD STE 109
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4328
Practice Address - Country:US
Practice Address - Phone:408-460-3867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT8263225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty